Individual
JODI LYN CREECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
(318) 429-5727
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
06433R
LA
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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